Schizophrenia is a multifaceted disorder that manifests by both genetic and environmental factors. A plethora of twin and adoption studies suggest major genetic influences on the pathogenesis of schizophrenia; however, a MZ concordance of 50% also suggests environmental factors (Cardno et al., 1999). [Note, a concordance of 100%, or absolute probability that both “identical” twins are afflicted or not, would suggest a single gene disorder, as in sickle cell anemia and cystic fibrosis.] These family studies reveal that schizophrenia is a complex genetic disorder, akin to diabetes and most cancers, where not but multiple causative genes contribute to susceptibility — a polygenetic disease. Moreover, there are presumably environmental factors that contribute to the onset.

In schizophrenia, vulnerability may include genetic predisposition, birthing complications, and CNS viral infections. Stressful life events (e.g. being fired from work, terminating a relationship, or moving to a foreign environment) and biological stressors (e.g. substance abuse) may exacerbate the illness by triggering the emergence or reoccurrence of symptoms. However, protective coping mechanisms may safeguard vulnerable persons by weakening or eliminating symptoms.

The vulnerability-stress-coping model demonstrates the composite mechanism of schizophrenia and provides a useful diagram for optimal combination therapy for clinical management.

Shaheen E Lakhan, MD, PhD, MEd, MS, FAAN, is a board-certified neurologist and pain specialist, medical educator, and scientist. He is the executive director of the Global Neuroscience Initiative Foundation (GNIF). He is a published scholar in biomarkers, biotechnology, education technology, and neurology. He serves on the editorial board of several scholarly publications and has been honored by the U.S. President and Congress.

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Founded in 2005 by Dr. Shaheen Lakhan, Brain Blogger is an official undertaking of the Global Neuroscience Initiative Foundation (GNIF) — an international charity for the advancement of neurological and mental health patient welfare, education, and research. It is one of the most effective mediums for the GNIF to raise awareness of neuro-related topics.